Characteristics of functionally optimal occlusion

and principles of occlusal rehabilitation

H enry L. Beyron, L.D .S., M .S.D ., Stockholm , Sweden

A general aim o f modern dental science sense of a specific arrangement of the

is to maintain and restore correct func­ teeth and specific intercuspation may
tion of the masticatory system. Correct constitute, but is not synonymous with,
function signifies that the system will per­ good function. Occlusion may vary con­
form the function for which it is intended siderably from this normal and yet con­
and in such a way as to place no un­ form to the requirements of good func­
necessary strain on its integral parts. tion. Conversely, occlusion may closely
Herein are contained two basic con­ approximate the anatomic normal with­
siderations: (1 ) T h e masticatory system out affording good function. Anatomi­
is a unitary system, each part of which— cally normal occlusion cannot, therefore,
the teeth, for instance— must be con­ be postulated as a basis of evaluation or
sidered in relation to the whole. (2 ) The as an aim of treatment. Neither can the
masticatory system is a functional system, basis be the morphologic averages, which
the prime object of which is to promote are based on mathematical calculation of
perfect conditions functionally rather mean values as, for instance, in M o n -
than morphologically. son’s1 spherical theory. There is no
Dental treatment is usually not applied specific pattern which can serve as a
directly to such structures as muscles or general basis for the appraisal of the
the temporomandibular joint but to the individual occlusion. Every case presents
teeth and to their conditions of contact; its own characteristics, and its treatment
that is, to the occlusion. T h e general aim must be directed toward the attainment
therefore may be referred to as function­ of the best functional conditions for that
ally optimal occlusion. This term signifies case.
occlusion that is in functional harmony W ith the research in the various fields
with the whole masticatory system, com­ as a basis, it is, however, possible to de­
prising the supporting tissues, the facial duce certain requirements or character­
skeleton, the muscles and the temporo­ istics of functionally optimal occlusion,
mandibular joints— occlusion that en­ although many gaps remain in our knowl­
sures efficient functioning without plac­ edge where there is ample scope for re­
ing undue strain on the integral struc­ search and many fields still call for in­
tures. T h e term rehabilitation of the oc­ tensified study. Nevertheless, by collating
clusion covers all forms of correction and the established characteristics, it is possi-
restoration of the adult dentition to this
end.
P resented in th e p o s tg ra d u a te course "A n a ly s is and
Functionally optimal occlusion must be T re a tm e n t o f th e S to m a to g n a th ic S y s te m ," C h ic a g o ,
N o rth w e s te rn U n iv ers ity D e n ta l S choo l, A p r il 1-3, W53.
distinguished from normal occlusion.
I. M onson, G . S . Som e Im p o r ta n t fa c to rs w hich in­
Anatomically “ normal” occlusion in the flu e n c e o c clus ion. J .A .D .A . 9:498 J une 1922.

648
 B E Y R O N . . . V O L U M E 48, J U N E 1954 • 64?

ble to form a fairly good concept of what tion, within certain limits, multiplies and
constitutes optimal occlusion. It is im­ strengthens the trabeculae. Reduced func­
portant to have a clear picture of optimal tion has the opposite effect. Both exces­
occlusion as a basis of evaluation or as a sive and insufficient functional usage have
goal for treatment. As a result of hazy unfavorable effects. There is thus a func­
concepts of optimal occlusion, many den­ tional optimum. Accordingly, a tooth
titions are allowed to remain unimproved should be subjected to a certain occlusal
under the very eyes of the dentist; and load and should not be permanently
those restorations that are provided lead without one; that is, it should always
all too frequently to dysfunction and con­ have an antagonist.
sequent breakdown of the dentition. The reaction of the periodontal mem­
The establishment of optimal occlusion brane is of particular interest. T h e tooth
is a problem of concern to many widely is suspended in collagenous fibers. Gott­
different branches o f odontology. The lieb and Orban5 and others have shown
purpose of this article is to set forth some that under longitudinal axial stress prac­
of the requirements and characteristics tically all the fibers resist the load and
of the form (pattern) of optimal occlu­ produce traction on the bone, which
sion, especially with regard to stress on stimulates bone apposition. The alveolar
the supporting tissues. These require­ bone and the fibers jointly sustain the
ments will form the basis of the principles load. W hen lateral stress is acting, the
of rehabilitation. force is taken up regionally. As a result
Certain of these characteristics and only some fibers produce traction, regions
principles are already recognized and re­ of pressure are formed, and bone resorp­
quire only a brief review; others require tion results. The supporting tissues thus
clarification. resist axial stress much better than lateral
stress.
S T R E S S O N T H E IN D IV ID U A L According to Box6 and Breitner7 it is
TOOTH
not the magnitude but the direction of
the force that is decisive. In normal mas­
The investigations on the reaction of the tication a force in the axial direction can
supporting tissues to the load on a single hardly be too great; it is necessary that
tooth are of primary importance. Present it should exceed a certain minimum in
knowledge is based on general studies of order to maintain the supporting tissues
the structure of the supporting tissues. A in a healthy condition. T h e unfavorable
stress to which a tooth is subjected acts effect of lateral stress is governed, in ad­
as a stimulus to this structure. It may be dition, by the frequency of application of
regarded as a force radiating from the the force and the period over which it
tooth via the cementum, the periodontal acts.
membrane and the cortical plate to the For the pattern of the occlusal surface,
supporting bone. T h e subordinate struc­
tures adapt themselves to the force.
In the bone, which is architecturally a 2. Benninghoff, A . D ie A r c h ite k tu r d e r K iefer und
ih re r W e ic h te ilb e d e c k u n g , P a ra d e n tiu m 3:50, 1934.
trabecular tissue, the trabeculae are 3. S e ip e l, C . M . T ra je c to rie s of th e |aws. A c ta
adapted in number and direction to the o d o n t. S c a n d in a v . 8:81 J une 1948.
4. W e in m a n n , J . P., a n d S icher, H a r r y . Bone and
functional requirements. Benninghoff,2 bones. S t. Louis, C . V . M o s b y C o ., 1947.

Seipel,3 and W einm ann and Sicher4 have 5. S o t t lie b , Bernhard , a n d O r b a n , B a lin t. D ie V e rä n ­
d e ru n g en d e r G e w e b e b e i ü b e rm ä s s ig e r Beänsspruchung
demonstrated that a change in the func­ d e r Z ä h n e . L e ip z ig , G e o r g T h îe m e , 1931.
6. Box, H . K. Tw elve p e rio d o n ta l s tudies. T o ro n to ,
tion, an increase in the load or a change U n iv ers ity o f T o ro n to Press, 1940.
in the direction of the force leads to 7. B reitner, C a r l. A lte r a t io n o f o c clu s al re la tio n s
in d u c ed b y e x p e rim e n ta l p ro c e d u re . A m , J , O r th o d o n t.
changes in the structure. Increased func­ & O r a l S u rg . 29:277 M a y 1943,
650 • T H E J O U R N A L O F T H E A M E R IC A N D E N T A L A S S O C IA T IO N

the direction of the force is the essential three tooth groups comprising the cuspids
factor. Purely axial and purely lateral and incisors in the anterior segment and
stresses occur but seldom. The variations the cuspids, bicuspids and molars in each
in the inclination of the axis and the lateral segment. Functionally, the cuspid
shape of the crown give rise to complex should be included in both the anterior
stresses. Generally, the more the force and the lateral segments. A n interproxi­
deviates from the direction of the long mal contact therefore is essential. The
axis, the less satisfactorily do the sup­ lateral forces which act on the teeth in
porting tissues resist that force. radial and transverse directions are not
Th e architecture of the bone and the distributed in this manner and are there­
condition of the supporting tissues in fore more unfavorable.
general are determined not only by func­ The distribution of the total load in
tion but by systemic factors, such as me­ such a manner that many teeth make
tabolism, nutrition, vitamin level and simultaneous occlusal contact has long
hormonal balance. T h e state of the sup­ been considered beneficial for the indi­
porting tissues is further influenced by vidual tooth and its supporting tissues.
local irritational factors. As a conse­ Distribution of occlusal stress is, generally
quence, the condition of the supporting speaking, a desirable characteristic.
tissues is determined by the combined It is logical that in centric position the
effect of all these factors. The occlusal total load should be distributed over all
load, in the form for instance of a lateral parts of the dental arch and thus over all
force, may therefore not in itself be said the teeth. The load is potentially the
to be “ detrimental” or “ traumatic.” The greatest in centric position.
terms “ favorable” and “ unfavorable” are In eccentric positions the load should
more appropriate. Optimal occlusion be distributed primarily over all the teeth
from the point of view of stress may be in the engaged segment, since in function
expressed as occlusion that is best calcu­ only one group of teeth comes into use at
lated to obviate periodontal destruction. a time. In a dentition with no large gaps,
For functionally optimal occlusion, the a force applied in incision is exerted only
teeth should receive stress consistent with on the anterior teeth and is not trans­
physiologic requirements for stimulation ferred to the lateral segments.8’ 9 There
of the supporting tissues; and, in par­ seems to be no reduction in the load on
ticular, the direction of stress should the anterior segment through simultane­
coincide as closely as possible with the ous use of bicuspids and molars. In mas­
long axis of the tooth. This principle is tication the force is applied mainly on
the principle of axial stress. the side where the bolus is placed, that
is, on the working side. Even when food
STRESSES ON T H E D E N T IT IO N is finely divided or when there is no food,
the load seems to be applied similarly,
A stress that may seem unfavorable for mainly on one side at a time. The real
the individual tooth and its supporting significance of stress distribution in ec­
tissues may not, in fact, be so, since the centric positions and its extent will be
tooth must be considered in relation to discussed later.
the larger system, the dentition. W hen the For functionally optimal occlusion the
teeth are in interproximal contact, the total load should be distributed through
lateral stress is distributed in a mesio-
distal direction to the adjacent teeth.
Since the dental arch changes in direc­ 8. S chuyler, C . H . Factors o f occlusion a p p lic a b le to
re s to ra tiv e d e n tis try . J . Pros. D en. 3:772 N o v . 1953.
tion at the cuspids, this distribution is 9. Jankelson, B ernard; H o ffm a n , G . M ., a n d H e n d -
ron, J . A . The physiology o f th e s to m a to g n a th ic system .
particularly operative within each of the J .A .D .A . 46:375 A p r il 1953.
 B E Y R O N . . . V O L U M E 48, J U N E 1954 • 651

interproximal contact and by simultane­

ous occlusal contact, in centric position
among all teeth and in eccentric position
primarily among the teeth in the engaged
tooth segment. This principle is the prin­
ciple of the distribution of stresses.

O C C L U S IO N IN C E N T R IC C L O S U R E

Axial stress and distribution of stresses

are two fundamental requirements that
have long been recognized. This concept,
however, is one of static occlusion and is
therefore insufficient. The concept must
be one of functional occlusion, conform­ Fig. 1 • A , three-dimensional range of incisive
ing to a dynamic pattern of the mandibu­ m ovem ent of lower incisors; B, median section
through A . A ll boundary movem ents, of which
lar movements and hence to the structure posterior hinge m ovem ent, P, is one, can be
of the whole masticatory system. repeated exactly. H abitual movem ents, H ,
The first criterion of occlusion is clo­ occur within range of m ovem ent and have a
varying course even in the individual
sure in centric relation. Centric relation
is a mandibulocranial relation and is
understood to imply a harmonious state opening and closing movements of the
of the temporomandibular joints and the mandible. It is instructive to follow the
musculature and of the relation between movements performed by the incisal point
them. of the lower incisor. Mandibular move­
The stress on the teeth should be ments are governed by the occlusal
studied primarily in centric relation and surfaces of the teeth, by the muscles and
not in the intercuspal position; that is, by the shape of the joint and its capsular
the position of the mandible determined ligament. If the extreme movements are
by the interdigitation of the cusps and recorded graphically, a characteristic fig­
the inclined planes of the teeth. On clo­ ure is obtained. In the horizontal plane
sure in centric relation it occasionally this figure is a rhomboid; by including
happens that some cusps or inclines make the opening movements, a three-dimen-
premature contact, after which the man­ sional figure is described (Fig. 1,A).
dible slides into an “ incorrect” intercuspal O f special interest is the most retruded
position, where several teeth make con­ opening and closing movement. This
tact. movement is indicated by the posterior
There are various concepts of what margin of the three-dimensional range of
centric relation implies and the manner movement and is best studied in a sagittal
in which it can be obtained. A discussion section (Fig. 1, 2 ). That the first part of
of centric relation as the “ ideal” relation an opening and closing movement, with
therefore is indicated. A knowledge of the mandible voluntarily retruded, is a
centric relation is of great importance, “ hinge movement” has been demon­
since direct observation of occlusal con­ strated by Fischer10 and M cCollum.11 A
tacts in the mouth is often unreliable and
should be supplemented by an examina­
tion of casts on an articulator. A record 10. Fischer, R. D ie O ffn u n g s b e w e g u n g e n des U n te r-
kiefers und ih re W ie d e r g a b e am A r tik u la to r . Schw eiz.
of centric relation is necessary. M o n a ts c h r. Z a h n h e ilk . 45:867 O c t . 1935.
A clearer view of centric relation may 11. M c C o llu m , B. B. F u n d a m en tals in v o lv e d in p r e ­
sc rib in g re s to ra tiv e d e n ta l r e m e d ie s . D . Item s In te res t
be obtained from the study o f the various 61:522 J une 1939.
652 • T H E J O U R N A L O F T H E A M E R IC A N D E N T A L A S S O C IA T IO N

graphic study made by the présent au­ position is obtained after rotatory closure
thor12 showed that this movement is ro­ through an adequate interocclusal space,
tatory and constant. By superimposed on an average 3 mm. A weakness in this
laminagraphic roentgenograms the hinge concept and method of determining cen­
character of the movement was further tric position is that the path of closure
confirmed, and the hinge axis was ob­ from the rest position to occlusion is
served to pass through, or close to, the translatory and seldom a rotation.13’ 17' 18
condyles. Posselt13 also has shown that Translatory movement seems natural in
the boundary movements of the mandi­ view of the character of the opening and
ble can be repeated exactly. The hinge closing movements. The rest position lies
movement is a boundary movement. in the upper distal range o f movement
T h e habitual movements of the m an­ but is not a boundary position (Fig. 2 ) .
dible during mastication, swallowing and For this reason the closure from the rest
speech are generally not boundary move­ position is a habitual movement and is
ments but occur within the range of subject to the same individual variation
movement (Fig. 1,B and Fig. 2 ) . The as other such movements. Consequently,
habitual opening and closing movement to accept the actual rest position for find­
has a varying path even in the indi­ ing the centric position seems inadvisable.
vidual.13’ 14 Nevertheless, the basic idea of a re­
M cC ollum ,11 Granger15 and others con­ laxed state of the musculature and un­
sider that the basic position for diagnosis strained joints that underlies the concept
and rehabilitation is reached at the cor­ of rest position is the same as that which
rect vertical dimension by hinge closure underlies the concept of centric relation.
in the retruded relation (Fig. 2 ) . They The best initial position for obtaining
call this centric position. Since this posi­ centric position, however, would appear
tion is assumed in a boundary movement, to be with the teeth in closer contact than
it may be repeated exactly, a factor which they are in the rest position.
is of immense value. According to Pos­ The clinical procedure employed by
selt13 this position is, on an average, 1.25 the author is as follows: T h e patient,
mm. distal to the intercuspal position, sitting in an upright position with the
with rather wide variation. Since the head approximately in the Frankfort
position is an intentionally retruded po­ horizontal plane, is asked to open and
sition, however, it would not appear to close the mouth repeatedly, completely
involve a harmonious state of the mus­ relaxing the muscles while doing so. This
cles and the temporomandibular joint. action is facilitated by swallowing or by
In the retruded position occasionally the moistening the lips. W hile executing the
total load may be carried entirely by only
a few teeth in the posterior region; this
12. Beyron, H . L. O r ie n te r in g s p r o b le m v id p ro te tis ka
condition results in unfavorable loading reko n s tru k tio n e r och b e tts tu d ie r. Svensk. T a n d l.-T id s k r.
35:1 F e b . 1942.
of these teeth. It seems desirable, then,
13. Posselt, U . Studies in th e m o b ilit y o f th e hum an
from the point of view of stress, to reg­ m a n d ib le . A c ta o d o n t. S c a n d in a v . 10 (S u p p l. 10) 1952.
14. Posselt, U . U n d e rk a e b e b e v a e g e ls e r o g ta n d a r tik u -
ister the retruded position and to dis­ la tio n . N o r d . M e d .-O d o n t. H a n d b o k , 1953, p . 861.
tribute the load, in this position, too, over 15. G r a n g e r , E. R. B io-m echanics o f p e r io d o n ta l, d is ­
ease. J . P e rio d o n t. 21:98 A p r il 1950.
a greater number of teeth. 16. Thom pson, J . R. The rest p o s itio n o f th e m a n d ib le
a n d its s ig n ific a n c e to d e n ta l scie n ce . J .A .D .A . 33:151
T h e rest position, “ the position the F e b . 1946. '
mandible assumes in rest in a tonal con­ 17. Bom an, V . R. A r o e n tg e n o g ra p h ic study o f th e
positio n o f th e m a n d ib le in n o rm a l occlusion o f the
traction of the musculature without out­ te e th . Thesis, N orth w e s te rn U n iv e rs ity D e n ta l School,
1948.
side interference,” has been conceived by
18. Thorne, H. T e le ro n tg e n c e p h a lo m e tris k p ro fìl-
Thompson16 and others as the primary analy s: system oversikt d ia g ra m fo r Downs system sam t
m a tm e th o d fo r " p a th o f c lo s u re ." Svensk. T a n d l.-T id s k r.
and fundamental position. The centric 44:30 F e b . 1951.
 B E Y R O N . . . V O L U M E 48, J U N E 1954 • 653

Fig. 2 • L e ft: H eavy-lined contour indicating range of incisive m ovem ent, in median plane, of
low er incisors. U pper posterior boundary line, P , indicates posterior hinge m ovem ent. R ig h t:
Enlargem ent o f detail on left. From intercuspal position, I, mandible may in most cases be m oved
som ewhat obliquely backward and downward to retruded contact position, D . T h e rest position,
R , lies in upper distal range of m ovem ent

relaxed opening and closing movement, As it has already been pointed out,
the patient is instructed to let the teeth occasionally it happens that only a few
occlude very lightly, to stop the occlusion teeth make contact on closure into cen­
at the initial contact and to hold the tric position. In that case, the load on
position without any sliding of the teeth. the teeth in premature contact and the
Examination then may reveal closure into sliding of the mandible into a forced
the intercuspal position— the intercuspal position produce stresses unfavorable to
position coinciding with centric relation the supporting tissues of the teeth and
— or it may show that some cusps or in­ probably at the same time disturb the
clines make premature contact, after temporomandibular joint.
which the mandible slides into an “incor­ For functionally optimal occlusion,
rect” intercuspal position. the mandible on closing in centric
In actual registration, a position should relation should close without interference
be recorded that is close to the occlusal into the position where cusps and in­
position, but without the cusps’ making clined planes interdigitate, that is, into
guiding contact and directing the man­ the intercuspal position. This principle is
dible. T h e closing movement to tooth the principle of closure without inter­
contact is practically a rotation, the dis­ ference in centric maxillomandibular re­
tance being so small that any deviation lation.
from this is negligible. Though this pro­
cedure for obtaining centric is not in­ OCCLUSAL V E R T IC A L D IM E N S IO N
fallible, it appears to be the best pro­
cedure for providing the ideal position Closely related to occlusion in centric
understood by centric position. position is the problem of occlusal verti­
654 • T H E J O U R N A L O F T H E A M E R IC A N D E N T A L A S S O C IA T IO N

cal dimension. It has no direct bearing ments such as attrition. This attrition ap­
on the pattern of occlusion and will pears to be due to gliding movements
therefore not be discussed at length. It is performed without food at some stage of
clear from investigations by Thompson16 life. A clear view of these processes can­
and others that a proper interocclusal not be obtained through single investiga­
clearance must exist between the rest tions. From the serial investigation on
position and the intercuspal, or occlusal, which a report is published in this issue
position. W ith the rest position as refer­ of t h e j o u r n a l , it appears that between
ence, it is then possible to determine the the occlusion and the contact gliding
correct occlusal vertical dimension. This movements there is a close reciprocal re­
manner of determination seems to be the lation. The position and the occlusion of
only acceptable one at present. There is, the teeth have a decisive influence on the
however, some uncertainty, since the gliding movements, and these in their
magnitude of the occlusal clearance, at turn influence the occlusal development.
one time accepted as 3 m m ., has since T h e adult dentition is subject to con­
been observed to vary widely. Clinical tinuous occlusal changes. T h e most fav­
experience shows, however, that en­ orable development from the point of
croaching on the interocclusal clearance view of occlusal stress appears to occur
in restorative work leads to serious in­ when there are multidirectional gliding
crease in the stress on the supporting movements. A somewhat less favorable
tissues, as the musculature attempts to form of occlusion will result when bi­
recover the individual’s original inter­ lateral movements predominate. W hen
occlusal clearance. A n unfavorable lever­ solely unilateral movements predomi­
age also is introduced, since the clinical nate, the development is unfavorable.
crown becomes too high in relation to the Knowledge concerning the form of oc­
clinical root. clusion that permits free gliding move­
For functionally optimal occlusion, the ments is of great importance. Gliding
occlusal vertical dimension should be de­ movements occur from the position where
termined by proper interocclusal clear­ several teeth are in contact and the in­
ance between the rest position and the clination of the gliding path is fairly flat.
intercuspal position, or occlusion. This Accordingly, the pattern of optimal oc­
principle is the principle of proper inter­ clusion requires simultaneous contact in
occlusal clearance. eccentric positions between teeth in the
engaged segment and gliding paths to­
O C C L U S IO N IN E X C U R S IV E wards centric position, that are flat or
M OVEM ENTS moderately steep.
A form of occlusion permitting multi­
T h e occlusion must conform also to ex­ directional gliding movements is the best.
cursive gliding movements with the teeth A steep incisal guidance with few teeth
in contact. This principle is for the most making contact in the protrusive position
part generally accepted. is a common condition, and in such cases
Some workers, including Kurth,19 Jan- bilateral movements will predominate. It
kelson and others,9 maintain that contact is, then, of importance to note that den­
gliding movements do not occur in mas­ titions with a bilateral movement pattern
tication and hence that excursive move­ have a development which is relatively
ments are not concerned in occlusion. favorable.
Jankelson’ s studies pertain only to move­ In treatment the steepness of the in-
ments in mastication. There is clinical
evidence, however, that most dentitions
19. Kurth, L. E. M a n d ib u la r m ovem ents in m a s tic a ­
present some signs of excursive move­ tio n . J .A .D .A . 29:1769 O c t . 1942.
 B E Y R O N . . . V O L U M E 48, J U N E 1954 • 655

cisal guidance can in most cases be re­ tact in eccentric positions. Treatment
duced but slightly. Nevertheless, in a then must be directed primarily to the
considerable number of cases a fairly flat correction of the malposition; orthodon­
lateral gliding path and simultaneous tic measures may be of value.
occlusal contact among several teeth in N o specific cuspal inclination can be
the lateral segment, involving cuspids, indicated for the shaping of the occlusal
bicuspids and molars, may be obtained on surface in restoration. Individual restora­
the working side, a situation which pro­ tions should be in harmony with the
motes lateral gliding movements and inclinations of the remaining teeth; these
thus a relatively favorable development. inclinations have often been obtained by
It has already been said that balancing grinding. W hen restorations are made for
contact on the unengaged side does not all bicuspids and molars, harmony should
contribute to a reduction in the stress be created with the guiding factors: in­
applied to the teeth on the working cisal guidance and condylar guidance. A t
side. In this connection the danger of ex­ the same time, the aim should be to
cessive contact of balancing cusp inclines make the cusps as flat as possible. T o this
should be emphasized, since such contact end, it is sometimes possible to modify
obstructs gliding movements. the inclination of the occlusal plane and
T h e inclination of the gliding paths the compensating curve. Occasionally the
and the number of teeth in contact that guiding factors make it necessary to form
will permit free gliding movements vary exceptionally steep cusps in order to ob­
with the individual. Young persons seem tain multiple contacts, especially bal­
to perform gliding movements with rela­ ancing contact. In such cases it is better
tively steep paths and with few teeth in to make the cusps more shallow even if it
contact. For the execution of the gliding is necessary to have fewer teeth in con­
movements, it is not necessary for all tact. The advantage of extensive stress
teeth in a segment to make contact and distribution is counteracted by the less
for the gliding paths to be completely flat. favorable direction o f stress and the ob­
W h at is essential is to have sufficient struction of free gliding movements.
teeth in contact and a sufficiently flat For functionally optimal occlusion, ex­
gliding path to promote gliding move­ cursive movements with the teeth in con­
ments. The establishment of this situation tact, especially lateral gliding, should be
is the real function of the simultaneous made without interference. T h e estab­
occlusal contact in the engaged tooth lishment of this objective is facilitated by
segment in eccentric positions. flat gliding paths and simultaneous con­
In correction by grinding, often only tact in eccentric positions between several
a small increase in the number of teeth teeth in the engaged tooth segment. This
in contact and a slight reduction in the principle is the principle of free gliding
inclination of the paths need be made to movements, especially lateral movements.
render lateral gliding movements pos­
sible. In the case of young persons, in S U M M A R Y A N D C O N C L U S IO N S
particular, only minor alterations are
necessary. The aim in correction is to Functionally optimal occlusion is occlu­
guide the occlusion into beneficial de­ sion in functional harmony with the in­
velopment. Great reduction in the cuspal tegral parts of the masticatory system. It
inclination and incisal guidance is rarely ensures efficient functioning without
indicated. Malposition, resulting from de­ placing undue strain on the integral
velopment or extraction, often leads to a parts. In particular, the occlusion should
condition in which there are steep glid­ be favorable to the supporting tissues of
ing paths and few teeth in occlusal con­ the teeth. There is no specific pattern of
656 • T H E J O U R N A L O F T H E A M E R IC A N D E N T A L A S S O C IA T IO N

functionally optimal occlusion which may mandible on closing in centric relation

serve as a general basis for the appraisal should close into the position where cusps
of the individual case. Functionally and inclined planes interdigitate without
optimal occlusion may vary considerably interference, that is, the intercuspal po­
in pattern. sition.
It is, however, possible to deduce from 4. Proper interocclusal clearance. The
research in various fields certain charac­ occlusal vertical dimension should be de­
teristics of functionally optimal occlusion, termined by proper interocclusal clear­
with particular regard to occlusal stress. ance between the rest position and the
These characteristics will provide the intercuspal position.
basis for the principles of rehabilitation. 5. Free gliding movements. Excursive
The main characteristics and principles movements with the teeth in contact,
which have been determined are: especially in lateral gliding, should be
1. Stress. The teeth should receive made without interference. The attain­
stress consistent with physiologic require­ ment of this objective is facilitated by
ments for the stimulation of the support­ flat gliding paths and simultaneous con­
ing tissues. Axial stress, that is, the direc­ tact in eccentric positions among several
tion of stress on the individual tooth, teeth in the engaged tooth segment.
should coincide as closely as possible with By collating these characteristics and
the long axis of the tooth. principles, it is possible to form a clear
2. Distribution of stresses. T h e total concept of what constitutes optimal oc­
load should be distributed by interproxi- clusion. First, with these characteristics as
mal tooth contact and by simultaneous a basis, it is possible to evaluate the occlu­
occlusal contact in centric position among sion of an individual. Secondly, by con­
all teeth and in eccentric positions pri­ ducting the treatment according to these
marily among the teeth in the engaged principles of rehabilitation, the best
tooth segment. functional conditions for the dentition of
3. Closure without interference in the individual can be realized.
centric maxillomandibular relation. The Norrmalmstorg 1

The Electricity of Viruses • H ow viruses attach themselves to the wall o f a bacterium before
they invade is a question that greatly interests virologists. Th eodore Puck and Bernard Saglik,
biophysicists at the University o f C olorado, have perform ed an ingenious experiment which
supports the idea that it is a simple electrical process.
T h e targets for the viruses in their experiment were not living bacteria but ion exchange
resins. It has been known that bacterial viruses attach themselves to cells only when positive
ions are present. This suggested that both viruses and cells normally are negatively charged,
and that the positive ions make it possible for them to get together by neutralizing the repulsive
force o f the like charges. T h e C olorado experimenters found that viruses readily attached them­
selves to positive resins, and would not stick to negative resins unless positive ions were added.
T h ey proved that cells, like viruses, also are negative: they attach to positive but not to negative
exchangers.
W hen certain bacterial viruses attach to a resin, they begin at once to separate into a protein
and a nucleic acid fraction. This parallels exactly their behavior in cells, where the nucleic acid
is injected into the cell and the protein “ coat” remains outside. Puck and Saglik, writing in
The Journal of Experimental Medicine, suggest that the splitting is the result o f simple electro­
static forces. Science and the Citizen. Scientific American 189:44 August 1953.